CURES: Health Insurance Companies Should Fund California's Crippled Prescription Database
We on the East Coast often look to California, the more progressive coast, as a bellwether. But the state has dropped the ball when it comes to its CURES prescription database. Funding was pulled at the end of last year, which is a blow to anyone concerned with the epidemic of prescription pill abuse.
Joan wrote about CURES here, in March and here, earlier this month. It’s the program that replaced the Prescription Drug Monitoring Program (PDMP) and allows pharmacists to check a database to learn whether customers wanting a prescription were filling the same prescription at another pharmacy, called “pharmacy shopping.” Both doctors and pharmacists could access the database. It’s still accessible but with very little staff and few participants.
As a New York Times article explains, Governor Brown cut the state budget of the Department of Justice, leaving the program in the lurch. The writer notes, however, that there were problems from the start. The main one seems to be that entering prescriptions into the database is optional, unlike some states’ programs. (Joan noted that “even the 49th poorest state, Kentucky, had a functioning data base and requires all doctors and pharmacists to use it.”
Here’s a quote from the article, from the executive director of the Prescription Monitoring Program Center of Excellence at Brandeis University in Waltham, Mass.: [If California does not fix its system,] “it will pay a huge price in terms of people who end up dying whose lives could have been saved, of people overdosing and going into hospitals, or nursing homes, or ultimately on disability.”
Ira Freeman, owner of North Hollywood"s Key Pharmacy, is one CA pharmacist who cares (he made headlines in 2009 for refusing to fill Anna Nichole Smith's pain pill prescriptions). In March he attended a meeting with representatives in the Attorney General’s Sacramento office to talk about CURES. The situation couldn’t appear any bleaker. He had read an article in the Bay Citizen and learned that only 4% of pharmacists in the state had signed up. “My frustration is one, that not enough pharmacists have signed up and two, the system is antiquated. Even though it’s supposed to be realtime, it takes roughly six or seven minutes to get the data. That’s a long time when you have someone looking you straight in the eye on the other side of the counter,” he said.
The only time doctor shopping gets air play is when a celebrity dies, he noted. But unfortunately, everyday citizens are doing it as well. “We want to see that patients with legitimate needs see legitimate physicians and have access to their medications,” he said. “But those who doctor shop are raising the costs for everyone. The drugs and office visits are often covered through insurance, and everyone down the line pays the cost. Everyday citizens can’t say it doesn’t affect them, it does. It adds to insurance premiums,” he explained.
Freeman recommends that insurance companies provide funding because they would directly benefit if doctor shopping decreased. He believes that for every $1 spent on drugs, there is $43 in associated medical costs. “So,” he concluded, “it’s in their best interest to fund the program.”